Slight lift, smaller areolas with minimal incisions possible? (photos)

Hi sabujohn,
The photos show that the bulk of your breast sits below the level of the fold with the breast meets the chest wall. As such, the first decision point would be if you wanted to remain the same size, with an improved shape, or be slightly smaller. In the setting of a goal smaller, a small breast reduction would allow active reshaping of the breast tissue internally, making the areola smaller, and removing the substantial amount of excess skin that you have. Alternatively, in the setting of a lift, the same maneuvers could be undertaken with the goal of keeping the breast around the same size but an improved position.
Unfortunately, both these options will produce scars, specifically a scar around the nipple, a vertical scar, and under the breast scar that you cannot see without a mirror. Given your goals of a "slight lift", it will be important to meet with a board certified plastic surgeon advance to explicitly discussed your goals, and the trade off between final breast size and shape and scarring.
Hope this helps.
Best,Christopher Pannucci MDBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, Washington

Hi, thank you for sharing your question. When the nipple position is at the lowest point on the breast, this is referred to as grade 3 ptosis. In your situation, a “minimal” lift without scars is not feasible. You are a better candidate for a formal lift procedure to reposition the nipples to the center of the breast.

Dear sabujohn,
my preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Dear Sabujohn,
Thank you for your inquiry about getting a breast lift with the goal of achieving smaller areolas and minimal scarring. Your pictures have been instrumental in assessing your situation.
Types of Breast Lifts:
There are four main types of breast lifts: Crescent, Donut, Lollipop, and Anchor.
Each type offers a progressively better lift, but also involves longer scars.
Your Specific Case:
Based on your pictures showing grade 3 breast ptosis (where the nipple hangs at the lowest portion of the breast), an Anchor or Inverted T breast lift would likely provide the best results. This involves:
A 360-degree incision around the areola.
A vertical incision from the nipple to the breast fold.
An incision along the infra-mammary crease.
Considerations for Areola Size Reduction:
Reducing the areola size necessitates a 360-degree incision around the areola. If scarring is a major concern for you, this needs to be considered carefully.
Decision Making:
It's crucial to weigh the desire for optimal lift results against the acceptance of resultant scarring. An Anchor lift would offer excellent results but with more visible scars, whereas a less invasive lift like a Peri-Areolar lift might result in less satisfactory lifting but with fewer scars.
I hope this information helps you in making an informed decision about which breast lift procedure aligns best with your goals and comfort level regarding scarring.
Please consult with a qualified plastic surgeon to discuss these options in detail and what to realistically expect in terms of outcomes and scarring.
Wishing you the best in your decision-making process.
Sincerely,

The length and the quality of the scar is important of course but the long lasting result is more important.You have severe ptosis, areola needs to befitted and reduced, three dimensional skin tightening needs to be done, so a breast lift- autoaugmentation technique would be a good solution.Auto- augmentation technique, which means your own tissue is prepared like an implant and fixed to the upper part of the pectoral muscle fascia from inside and gives implant effect and gives upper pole fullness and also internal bra which means special suture technique to give more support.

Based on limited photos - you appear to be a candidate for an extended mastopexy/ lift in order to achieve the perkiest breasts. I do not believe that anything short of this plan will help you achieve a satisfactory result. I suggest that you seek an experienced Board Certified PS and discuss the details

You're welcome for the photos. Based on the photo, there will be incisions around the areola, along the fold underneath the breast, and connecting these lines. However, a more definitive decision can be made during a physical examination. Taking early precautions for scars is also important.

You cannot assume that you will scar poorly on your breasts just because you scar poorly elsewhere on your body. Fortunately, breasts are a favorable and forgiving place to put incisions, and they won't look like scars on your extremities or back. Further, light skin people of African descent heal extremely well from breast lift scars. Your breasts are large and have substantial sagging, you need a full 'anchor' lift scar pattern to look pretty. Go to a surgeon expert in breast surgery and you will like do very well.

You have third degree ptosis and need a full breast lift. Any minimal incision would not change your shape and you would still have some scars. I would either have a full lift to reshape you breasts and deal with the scars with your surgeon post op or I would accept your breasts as they are and have no surgery. Good luck.

Your breasts are low on the chest wall and the nipples are pointing downward. The technique I recommend is a breast lift using The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.